三种复合型骨移植材料早期修复骨缺损的比较
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摘要
目的:通过建立简易骨缺损模型,将珊瑚羟基磷灰石(CHA)与富血小板纤维蛋白(PRF)的复合物、珊瑚羟基磷灰石与自体骨的复合物、珊瑚羟基磷灰石与重组人骨形成蛋白-2(rhBMP-2)的复合物以及单纯珊瑚羟基磷灰石这四种骨移植材料分别植入相同的骨缺损区;比较四组骨移植材料在早期不同时段的骨缺损修复能力。方法:在6只比格犬双侧胫骨干骺端制备四个相同骨缺损,分别植入PRF/CHA、自体骨/CHA、rhBMP-2/CHA、CHA;术后第2、4、8周于比格犬颈部皮下分别注射盐酸四环素,钙黄绿素,茜素红行荧光标志;12周后处死比格犬、取材,观察四组大体标本植骨区骨生长情况,制作硬组织切片,测量荧光标记率,比较不同植骨区不同时段的新骨形成量。结果:大体标本见四组骨缺损间隙均完全关闭,植骨区无明显差异。硬组织切片观察:2周后四组均可见橙黄色荧光带,即均有新骨形成,成骨量:自体骨/CHA组>PRF/CHA组≈rhBMP-2/CHA组>CHA组;术后2~4周,绿色荧光带明显增多,四组成骨能力均增强,成骨量:自体骨/CHA组>PRF/CHA组≈rhBMP-2/CHA组>CHA组;4~8周均有红色荧光带,成骨量:PRF/CHA组>自体骨/CHA组>rhBMP-2/CHA组>CHA组。结论:12周内,三种复合型骨移植材料的成骨效能均明显优于单独使用珊瑚羟基磷灰石;三组复合型骨移植材料在早期不同时段的成骨量不同,自体骨/CHA组成骨效能最强,PRF/CHA组优于rhBMP-2/CHA组;术后2周,四组骨移植材料均有新骨形成,随着时间延长,新骨量增多。
Objective: Through the establishment of a simple model of bone defect, the complex of escoral hydroxyapatite(CHA)and platelet rich fibrin(PRF), the complex of coral hydroxyapatite and autogenous bone, the complex of coralline hydroxyapatite and recombinant human bone morphogenetic protein-two(rhBMP-2) and pure coral hydroxyapatite, four types of bone graft materials were implanted into four same bone defect areas. Then the ability of bone defect repair was compared between the four groups of bone graft materials in early different stages. Methods: Four bone defect areas were prepared in the six beagle dogs of canine bilateral tibial metaphyseal and were implanted with PRF/CHA, autogenous bone/CHA, rhBMP-2/CHA and CHA. The neck subcutaneou of six beagle dogs was injected with tetrac-ycline rochloride, calcein, alizarin red after second, fourth and eighth week, The six beagle dogs were executed and drawn after twelfth week, then bone growth condition of four bone graft areas was observed by gross specimen, hard tissue slices were made to compare the new bone formation in different bone graft area at different time by measuring fluorescence labeling rate. Results: Four groups of bone defect areas were completely closed in the gross specimen and there was no significant difference between the four groups of bone defect areas. Hard tissue slices observation result:four groups of bone defect areas showed orange fluorescence band after second week,namely new bone was found, the quantity of new bone:autogenous bone/CHA group>PRF/CHA group≈rhBMP-2/CHA group>CHA group, the green fluorescence band was increased significantly after second to fourth week,namely osteogenic ability was enhanced, the quantity of new bone:autogenous bone/CHA group >PRF/CHA group ≈rhBMP-2/CHA group >CHA group, the four groups of bone defect areas showed red fluorescence after fourth to eighth week, the quantity of new bone: PRF/CHA group >autogenous bone/CHA group>rhBMP-2/CHA group>CHA group. Conclusion: During the twelve weeks, the osteogenesis effects of three kinds of composite bone graft materials were significantly better than that the pure coral hydroxyapatite, In the early stage, the quantity of new bone of three groups of composite bone graft materials were different in different time and autogenous bone/CHA group was best, PRF/CHA group was better than rhBMP-2/CHA group, after second week of operation, new bone was found in four groups of bone defect areas, the longer,the more of the quantity of new bone.
Objective: Through the establishment of a simple model of bone defect, the complex of escoral hydroxyapatite(CHA)and platelet rich fibrin(PRF), the complex of coral hydroxyapatite and autogenous bone, the complex of coralline hydroxyapatite and recombinant human bone morphogenetic protein-two(rhBMP-2) and pure coral hydroxyapatite, four types of bone graft materials were implanted into four same bone defect areas. Then the ability of bone defect repair was compared between the four groups of bone graft materials in early different stages. Methods: Four bone defect areas were prepared in the six beagle dogs of canine bilateral tibial metaphyseal and were implanted with PRF/CHA, autogenous bone/CHA, rhBMP-2/CHA and CHA. The neck subcutaneou of six beagle dogs was injected with tetrac-ycline rochloride, calcein, alizarin red after second, fourth and eighth week, The six beagle dogs were executed and drawn after twelfth week, then bone growth condition of four bone graft areas was observed by gross specimen, hard tissue slices were made to compare the new bone formation in different bone graft area at different time by measuring fluorescence labeling rate. Results: Four groups of bone defect areas were completely closed in the gross specimen and there was no significant difference between the four groups of bone defect areas. Hard tissue slices observation result:four groups of bone defect areas showed orange fluorescence band after second week,namely new bone was found, the quantity of new bone:autogenous bone/CHA group>PRF/CHA group≈rhBMP-2/CHA group>CHA group, the green fluorescence band was increased significantly after second to fourth week,namely osteogenic ability was enhanced, the quantity of new bone:autogenous bone/CHA group >PRF/CHA group ≈rhBMP-2/CHA group >CHA group, the four groups of bone defect areas showed red fluorescence after fourth to eighth week, the quantity of new bone: PRF/CHA group >autogenous bone/CHA group>rhBMP-2/CHA group>CHA group. Conclusion: During the twelve weeks, the osteogenesis effects of three kinds of composite bone graft materials were significantly better than that the pure coral hydroxyapatite, In the early stage, the quantity of new bone of three groups of composite bone graft materials were different in different time and autogenous bone/CHA group was best, PRF/CHA group was better than rhBMP-2/CHA group, after second week of operation, new bone was found in four groups of bone defect areas, the longer,the more of the quantity of new bone.
引文
1 Mauffrey C,Barlow B,Smith W.Management of segmental bone defects[J].Am Acad Orthop Surg,2015,23(3):143-153
2 Herford A,Nguyen K.Complex bone augmentation in alveolar ridge defects[J].Oral Maxillofac Surg Clin North Am,2015,27(2):227-244
3 Clara M.Towards an animal-centred ethics for Animal-Computer Interaction[J].International Journal of Human-Computer Studies,2017,9(8):221-233
4 王忠东,陈俊兰,陈觉尧,等.个体钛支架复合珊瑚羟基磷灰石和重组人骨形成蛋白2修复兔下颌骨缺损[J/CD].中华口腔医学研究杂志:电子版,2012,6(4):336-341
5 Zhang D Y,DU N,Liu Y E,et al.[The experimental study of subcutaneous ectopic ossification with different proportional mixtures of human autologous bone and hydroxyapatite in nude mice[J].Shanghai kou qiang yi xue Shanghai journal of stomatology,2013,22(6):655-658
6 郭泽鸿,容明灯,朱安棣,等.含种植体硬组织骨计量学不脱钙塑料包埋技术[J].广东医学,2008,29(3):385-386
7 王东胜,刘洪臣,吕燕,等.带种植体骨磨片的标准化制作[J].中华老年口腔医学杂志,2008,6(4):203-205
8 Young T A,Cunningham C C,Bailey S M.Reactive oxygen species production by the mitochondrial respiratory chain in isolated rat hepatocytes and liver mitochondria:studies using myxothiazol[J].Archives of Biochemistry and Biophysics,2002,405(1):65-72
9 虞惊涛,马信龙,马剑雄等.骨质疏松动物模型评价方法[J].中华骨质疏松和骨矿盐疾病杂志,2014(1):66-70
10 Koo S,Konig B,Allegrini S,et al.Titanium implant osseointegration with calcium pyrophosphate in rabbits[J].Journal of Biomedical Materials Research Part B:Applied Biomaterials,2006,76(2):373-380
11 Rickert D,Vissink A,Slot W J,et al.RaghoebarMaxillary sinus floor elevation surgery with Bio Oss(r)mixed with a bone marrow concentrate or autogenous bone:test of principle on implant survival and clinical performance[J].International Journal of Oral&Maxillofacial Surgery,2014,43(2),pp.243-247
12 Kumar N K,Shaik M,Nadella K R,et al.Chintapalli Balakrishna Manohar Compa-rative study of alveolar bone height and implant survival rate between autogenous bone mixed with platelet rich plasma versus venous blood for maxillary sinus lift augmentation procedure[J].Journal of maxillofacial and oral surgery,2015,14(2),417-422
13 刘鹏,马敏杰,杨小彬,等.纳米人工骨混合自体骨用于骨肿瘤骨切除后填充效果[J].现代仪器与医疗,2016,22(5):33-36
14 Georgiannos D,Lampridis V,Bisbinas I.Phenolization and coralline hydroxyap-atite grafting following meticulous curettage for the treatment of enchondroma of the hand.A case series of 82 patients with 5-year follow-up[J].HAND,2015,10(1):111-5
15 Albayrak O,Ipekoglu M,Mahmutyzicioglu N,et al.Preparation and characteri-zation of porous hydroxyapatite pellets:Effects of calcination and sintering on the porous structure and mechanical properties[J].Proceedings of the Institution of Mechanical Engineers Part L Journal of Materials Design&Applications,2015:1-9
16 曾吉阳.骨移植材料BMP/b FGF/XACB的异位成骨实验研究.贵州医科大学硕士毕业论文,2017
17 陈泽鹏.DS/rh BMP-2/CS复合微球联合CHA人造骨修复大段骨缺损的成骨化和血管化研究.广州中医药大学硕士毕业论文,2017
18 李春威,陈珺.rh BMP-2复合牛松质骨载体对兔同种异体眶骨移植愈合影响的实验研究[J].全科医学临床与教育,2016,14(5):488-491
19 Dohan D M,Choukroun J,Diss A,et al.Plateletrich fibrin(PRF):a second-gen eration platelet concentrate.Part I:technological concepts and evolution[J].Oral Sur gery,Oral Medicine,Oral Pathology,Oral Radiology,and Endodontology,2006,101(3):e37-e44
20 Zhou C M,Li S H,Wen Q G,et al.The expressions of the Notch and Wnt signaling pathways and their significance in the repair process of alveolar bone defects in rabbits with bone marrow stem cells compounded with platelet-rich fibrin[J].Hua xi kou qiang yi xue za zhi=Huaxi kouqiang yixue zazhi=West China journal of stomatology,2016,34(2):130-5
21 Tian Z,Hua W Y,Zhuo W T,et al.Effect of Choukroun Platelet-Rich Fibrin Combined With Autologous Micro-Morselized Bone on the Repair of Mandibular Defects in Rabbits[J].Journal of Oral and Maxillofacial Surgery,2017
22 Yi F L,Li J C,Seemun R,et al.Osteoporosis influences osteogenic but not angiogenic response during bone defect healing in a rat model[J].Injury,2013,44(7):923-929
23 刘德裕.PRF在即刻种植负重种植体周围骨缺损修复中应用的实验研究.中南大学硕士毕业论文,2012
24 Takahashi Y,Yamamoto M,Tabata Y.Enhanced osteoinduction by controlled release of bone morphogenetic protein-2 from biodegradable sponge composed of gelatin andβtricalcium phosphate[J].Biomaterials,2005,26(23):4856-4865
25 Schwarz F,Herten M,Sager M,et al.H istological and immuno histochemical analysis of initial and early osseous integration at cheni ically modified and conventional SLA titanium im plants:prelim inary results of a pilot study in dogs.Clin Oral Implants Res,2007,18(4):481-488
2 Herford A,Nguyen K.Complex bone augmentation in alveolar ridge defects[J].Oral Maxillofac Surg Clin North Am,2015,27(2):227-244
3 Clara M.Towards an animal-centred ethics for Animal-Computer Interaction[J].International Journal of Human-Computer Studies,2017,9(8):221-233
4 王忠东,陈俊兰,陈觉尧,等.个体钛支架复合珊瑚羟基磷灰石和重组人骨形成蛋白2修复兔下颌骨缺损[J/CD].中华口腔医学研究杂志:电子版,2012,6(4):336-341
5 Zhang D Y,DU N,Liu Y E,et al.[The experimental study of subcutaneous ectopic ossification with different proportional mixtures of human autologous bone and hydroxyapatite in nude mice[J].Shanghai kou qiang yi xue Shanghai journal of stomatology,2013,22(6):655-658
6 郭泽鸿,容明灯,朱安棣,等.含种植体硬组织骨计量学不脱钙塑料包埋技术[J].广东医学,2008,29(3):385-386
7 王东胜,刘洪臣,吕燕,等.带种植体骨磨片的标准化制作[J].中华老年口腔医学杂志,2008,6(4):203-205
8 Young T A,Cunningham C C,Bailey S M.Reactive oxygen species production by the mitochondrial respiratory chain in isolated rat hepatocytes and liver mitochondria:studies using myxothiazol[J].Archives of Biochemistry and Biophysics,2002,405(1):65-72
9 虞惊涛,马信龙,马剑雄等.骨质疏松动物模型评价方法[J].中华骨质疏松和骨矿盐疾病杂志,2014(1):66-70
10 Koo S,Konig B,Allegrini S,et al.Titanium implant osseointegration with calcium pyrophosphate in rabbits[J].Journal of Biomedical Materials Research Part B:Applied Biomaterials,2006,76(2):373-380
11 Rickert D,Vissink A,Slot W J,et al.RaghoebarMaxillary sinus floor elevation surgery with Bio Oss(r)mixed with a bone marrow concentrate or autogenous bone:test of principle on implant survival and clinical performance[J].International Journal of Oral&Maxillofacial Surgery,2014,43(2),pp.243-247
12 Kumar N K,Shaik M,Nadella K R,et al.Chintapalli Balakrishna Manohar Compa-rative study of alveolar bone height and implant survival rate between autogenous bone mixed with platelet rich plasma versus venous blood for maxillary sinus lift augmentation procedure[J].Journal of maxillofacial and oral surgery,2015,14(2),417-422
13 刘鹏,马敏杰,杨小彬,等.纳米人工骨混合自体骨用于骨肿瘤骨切除后填充效果[J].现代仪器与医疗,2016,22(5):33-36
14 Georgiannos D,Lampridis V,Bisbinas I.Phenolization and coralline hydroxyap-atite grafting following meticulous curettage for the treatment of enchondroma of the hand.A case series of 82 patients with 5-year follow-up[J].HAND,2015,10(1):111-5
15 Albayrak O,Ipekoglu M,Mahmutyzicioglu N,et al.Preparation and characteri-zation of porous hydroxyapatite pellets:Effects of calcination and sintering on the porous structure and mechanical properties[J].Proceedings of the Institution of Mechanical Engineers Part L Journal of Materials Design&Applications,2015:1-9
16 曾吉阳.骨移植材料BMP/b FGF/XACB的异位成骨实验研究.贵州医科大学硕士毕业论文,2017
17 陈泽鹏.DS/rh BMP-2/CS复合微球联合CHA人造骨修复大段骨缺损的成骨化和血管化研究.广州中医药大学硕士毕业论文,2017
18 李春威,陈珺.rh BMP-2复合牛松质骨载体对兔同种异体眶骨移植愈合影响的实验研究[J].全科医学临床与教育,2016,14(5):488-491
19 Dohan D M,Choukroun J,Diss A,et al.Plateletrich fibrin(PRF):a second-gen eration platelet concentrate.Part I:technological concepts and evolution[J].Oral Sur gery,Oral Medicine,Oral Pathology,Oral Radiology,and Endodontology,2006,101(3):e37-e44
20 Zhou C M,Li S H,Wen Q G,et al.The expressions of the Notch and Wnt signaling pathways and their significance in the repair process of alveolar bone defects in rabbits with bone marrow stem cells compounded with platelet-rich fibrin[J].Hua xi kou qiang yi xue za zhi=Huaxi kouqiang yixue zazhi=West China journal of stomatology,2016,34(2):130-5
21 Tian Z,Hua W Y,Zhuo W T,et al.Effect of Choukroun Platelet-Rich Fibrin Combined With Autologous Micro-Morselized Bone on the Repair of Mandibular Defects in Rabbits[J].Journal of Oral and Maxillofacial Surgery,2017
22 Yi F L,Li J C,Seemun R,et al.Osteoporosis influences osteogenic but not angiogenic response during bone defect healing in a rat model[J].Injury,2013,44(7):923-929
23 刘德裕.PRF在即刻种植负重种植体周围骨缺损修复中应用的实验研究.中南大学硕士毕业论文,2012
24 Takahashi Y,Yamamoto M,Tabata Y.Enhanced osteoinduction by controlled release of bone morphogenetic protein-2 from biodegradable sponge composed of gelatin andβtricalcium phosphate[J].Biomaterials,2005,26(23):4856-4865
25 Schwarz F,Herten M,Sager M,et al.H istological and immuno histochemical analysis of initial and early osseous integration at cheni ically modified and conventional SLA titanium im plants:prelim inary results of a pilot study in dogs.Clin Oral Implants Res,2007,18(4):481-488